Nursing Elites

1. A healthcare provider is preparing to administer a scheduled dose of intravenous (IV) metoprolol (Lopressor) to a client. The client's apical pulse is 58 beats/minute. What action should the healthcare provider take?

• A. Administer the medication as prescribed.
• B. Hold the medication and notify the healthcare provider.
• C. Give half the prescribed dose and recheck the pulse in 30 minutes.
• D. Administer the medication and then recheck the pulse in 30 minutes.

Correct answer: B

Rationale: In the scenario described, with the client's apical pulse being 58 beats/minute, holding the medication and notifying the healthcare provider is the correct action. A low pulse rate may indicate bradycardia and may necessitate dose adjustment or further evaluation by the healthcare provider to prevent potential complications.

2. Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

• A. Continuous tube feeding at 65 ml/hr via gastrostomy.
• B. Total parenteral nutrition to be infused at 125 ml/hour.
• C. Nasogastric tube connected to low intermittent suction.
• D. Metoclopramide (Reglan) intermittent piggyback.

Correct answer: A

Rationale: In a client with dysphagia, hypoactive bowel sounds, and a firm, distended abdomen post-CVA, continuous tube feeding at 65 ml/hr via gastrostomy may exacerbate abdominal distension and hypoactive bowel sounds. This situation requires immediate assessment and reevaluation before continuing with the prescription.

3. A client with liver cirrhosis and ascites is being treated with spironolactone. What is a key nursing consideration for this medication?

• A. Monitoring for signs of hyperkalemia
• B. Checking for signs of hypoglycemia
• C. Assessing for signs of dehydration
• D. Observing for symptoms of hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia as it helps retain potassium in the body. Therefore, monitoring for signs of hyperkalemia such as muscle weakness, arrhythmias, or ECG changes is crucial to prevent potential complications.

4. The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?

• A. 9 mg
• B. 18 mg
• C. 27 mg
• D. 36 mg

Correct answer: A

Rationale: To calculate the dosage, first, convert the weight from pounds to kg (4 lbs / 2.2 ≈ 1.82 kg). Then, multiply by the prescribed mg/kg (15 mg/kg * 1.82 kg ≈ 27.3 mg). However, since the question asks for the closest correct option, the infant will receive approximately 9 mg.

5. A patient with hyperthyroidism is to receive radioactive iodine therapy. What information should the nurse include in the patient teaching plan?

• A. Avoid close contact with pregnant women for one week.
• B. Take iodine supplement daily.
• C. Restrict fluid intake to 1 liter per day.
• D. Use disposable utensils for all meals.

Correct answer: A

Rationale: The correct answer is to avoid close contact with pregnant women for one week. This precaution is essential to prevent radiation exposure to vulnerable populations. Pregnant women and small children are more sensitive to radiation, making it crucial for patients undergoing radioactive iodine therapy to avoid close contact with them for a specified period. Choices B, C, and D are incorrect because taking iodine supplements daily is not necessary for patients receiving radioactive iodine therapy. Restricting fluid intake to 1 liter per day is not a standard recommendation for radioactive iodine therapy. Using disposable utensils for all meals is not a specific precaution related to radioactive iodine therapy.

Similar Questions